This study examines the multilevel relationships between robotic quality (RQ), lean leadership (LL) and sustainable healthcare services (SHS), focusing on how LL moderates and serves as a necessary condition for aligning robotic technologies with sustainability goals in healthcare. The research is concerned with the special challenges of the integration of emerging technologies in the healthcare sector in resource-constrained environments, including Iraq.
A multilevel analytical approach was adopted, making use of multilevel modelling (MLM) and necessary condition analysis (NCA) to examine individual as well as organisational level interactions. Data were gathered from 858 healthcare professionals practising in public and private hospitals using a self-administered survey, distributed in three phases. Measurement models were validated with the help of confirmatory factor analysis (CFA), and multilevel relationships were tested with the help of regression and necessity analyses.
The findings depict that RQ has a positive influence on SHS at both personal and organisational levels. The latter is moderated by LL substantially, and weaker at the organisational level, where systemic leadership contributes to strategic alignment, optimisation of resources, and cultural change. The additional results of NCA confirm that LL is an obligatory requirement for sustainability, and it helps to eliminate systemic inefficiencies, develop lean practices, and combine robotic technologies and long-term sustainability objectives.
This article develops he theoretical understanding of multilevel leadership-technology-sustainability dynamics in healthcare. It offers empirical support that LL is not just a decisive element but a necessity that is vital to the delivery of sustainable results, especially in a resource-restricted setting. The results provide useful guidance to policymakers and hospital administrators on how to use leadership and RQ to develop long-lasting, effective and resilient healthcare systems.
